captioning sponsored by macneil/lehrer productions >> brown: president obama and mitt romney logged thousands ofa miles today covering states where the election remains a dead heat. good evening, i'm jeffrey brown. >> ifill: and i'm gwen ifill. on the "newshour" tonight, we take you on the road, as the candidates and their running mates blitz the battleground states. >> brown: then, we look at some surprisingly tight conidsts for open senate seats.fo >> ifill: what's not being talked about on the campaign trail? that's the focus of our new series. tonight's missing issue: the housing crisis. >> brown: four long shots for the presidency got their turn to

debate last night. kwame holman reports on the faceoff among the third party hopefuls. >> ifill: betty ann bowser tells the story of a sttle medical center cutting costs edd improving patient care by rethinking he services a hospital provides. >> waiting rooms are total waste.he ther is no reason for a waiting room. it's just an embarrassing reminder of how inefficient we are in healthcare delivery.th >> brown: and judy woodruff gets an inside look at the closed kingdom of saudi arabia from journalist and author karen elliot house. >> it's a country we're very dependent upon for oil and dependent upon to keep its people from becoming terrorists and trying to kill us. >> brown: that's all ahead on tonight's "newshour." major funding for the pbs newshour has been provided by: >> computing surrounds us. sometimes it's obvious and sometimes it's very surprising in where you find it.c2 soon, computing intellince innc

unexpected places will change our lives in truly profound ways. technology can provide customized experiences tailored to individual consumer preferences, igniting a world of possibilities from the inside out. sponsoring tomorrow, starts today. and with the ongoing suort of these institutions and foundations. and...t this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you.a thank you.

>> brown: the countdown to election day brought new jibes, new ads and new urgency today. the presidential contenders and their running mates raced from state to state, lookinto naill down 270 electoral votes with just 13 days to go. for president obam it was the busiest day yet of his re-s election campaign and it began with a flightrom washington to davenport, iowa. >> this is the first stop on our 48-hour fly-aroundroampaign marathon extravaganza. (am cheers and applause ) we're going to pull an all- nighter-- no sleep. >> brown: before the day was done, the president pland , to fly more than,000 miles fromes wa he was headed to coloradas califoiao and neva.ev rebl ican chaenttger mihar was also on t mlsove in e opposite directionteti

starting with an event in nevada, and planning to end the day in iowa. president obama won iowa in 2008, but it's a toss-up this year. he argued today t choice is between a known quantity and a cane date who keeps changing his views.da >> trust matters. and... and... and here's the thing. iowa, you know me. you know... you know that i say what i mean and i mean what iu say. you could take a videotape of things i've said 10 yrs ago, 12 years ago and o,u'd say, man, this is the same guy, has t ty, same values, cares about the same people... ( cheers ) ...doesn't forget where he came from. knows who he's fighting for. ( cheers ) >> brown: the president also told the "s moines register" that if he wins, a big reason will be that republicans "alienated the sts est-growing demographic group in theow country, the latino community."

he predicted the g.o.p. will join him in finally passing major migration reform.jo for his part, romney fired back in reno, nevada. he said the president's been reduced to misplaced attacks on his record. >> with four...our debates behind us, including the vice presidential debate, the president's been unable to find an... an agenda and to communicate an agenda and to defend an agenda.ba and that's one reason why i think we all know that he's out of ideas and out of excuses. and in november, you're going to put him out of office. >> reporter: for both sides, the stepped-up pace was a sign of just how tight the race is, in the closing stage of the campaign. over the next 13 daysboth candidates will barnstorm a series of swing states where the white house will be won or lost. perhaps none more important than ohio, where the vice presidential candidates were campaigning. >> well, folks, you probably heard the rumor that ohio is going to pick the next president

of the united states of america. and i'm happy about that. >> reporter: vice president biden talked up the president's economic ideas before crowd in marion, ohio. i >> folks, here's the deal, when the middle class is doing well, everybody does well. the poor have a way up-- they got a ladder up-- and the wealthy do very, very well. d we've created a lot of millionaires. and it's a good thing, not a ba thing. but that's how you do it. you don't grow from the top down. >> reporter: at roughly the same time, republican vice presidential nominee paul ryan was also addressing poverty 120 miles away, in cleveland. >> so what is the alternative approach that mitt romney and i are offering? well, to hear some tell it, we think everybody should just fend for themselves. that's just a false argument. it's a straw man set up to avoid a genuine debate. the truth is mitt romney and i believe in true compassion and upward mobility. and we're offering a vision based on real reforms for

lifting people out of poverty. >> reporter: a new wave of t.v. ads also debuted in key states. the pro-romney group american crossroads ban airing this spot in seven states with actor clint eastwood. >> when someone doesn't get the job done, you've got to hold them accountable. obama's second teds would be a rerun of the first and our country just can't survive that >> brown: the obama campaign countered with a reminder that just 537 votes in florida swung the election of 2000 and led to the george w. bush presidency. >> if you're thinking your vote doesn't count, that it w't matter, well, back then, there were probably at least 537 people who felt the same way. >> reporter: meanwhile, aides said the president would himselt be calling voters tonight from air force one before starting the day tomorrow in florida. mitt romney will be headed to ohio tomorrow. >> ifill: still to come on the "newshour": some unexpected tossups for senate seats; an

issue candidatesren't addressing: the housing crisis; the rest of the presidential field debates; cost-cuttire in a seattle medical center and a portrait of saudi arabia.n but first, with the other news of the day. here's hari sreenasan. >> sreenivasan: the u.s. economy is improving moderately, but hiring remains sluggish. that assessment came from the federal reserve today, after a two-day policy meeting. d stopped short of taking any further action.th instead, it's proceeding with a new bond-buying program it launched last month in a bid to bolster growth. on wall street, the fed's assessment of the economy put a brake on efforts to recover fro. yesterday's big sell-off. instead, the dow jones industrial average lost 25 points to close at 13,077. f the nasdaq fell more than eight points to close at 2,981. europe'seuconomic troubles are getting even worse. the european union reported today that the overall government debt of euro-zope countries has hit 90% of their total economic output for the year. that's the highest level sinceo-

the euro was launched in 1999. five of the nations that use the euro are already officially in recession: greece, spain, italy, portugal and cyprus. an islamist group was quick to claim it attacked the u.s. consulate in benghazi, libya and the white house was told almost immediately. the associated press reported that today. it said the state department e- mailed the information to the white house two hours after the attack. the e-mail cited claims by ansar al-sharia, on social media. but secretary of state hillary clinton said today the information was not solid. >> postinsomething on facebookst is not in and of itself evidence, and i think it just underscores how fluid the reporting was at the time and continued for some time to be. what i keep in mind is that four brave americans were killed and we will find out what happened. >> sreenivan: republicans charge the president and top

aides knew it was a terrorist attack early on, but played down that angle for political reasons. a new burst of violence has erupted along gaza's border wanh israel. fighters from hamas and a smaller militant group launched more than 70 rockets and mortar rounds at southern israel. two foreign workers were critically woded. the israeli military answered with air strikes inside gaza that killed at least two palestinians.y the israelis also warned they will launch a ground offensive, if the rocket fire doenot stop. a late-seasonurricane struck a blow at jamaica late today. it was expected to head on to cuba tonight.as urricane "sandy" brought heavy rain and strong winds to eastern jamaica, especially around the capital, kingston. the storm prompted airports to close and cruise ships to change course. those are some of the day's major stories. now, back to gwen. >> ifill: the presidential race is not the only campaign working its way toward a photo finish this year. in competitive contests from east to west, the race for the senate has turned out to be tigh expensive and slippery.ti in arizona, democrat and former surgeon izneral richard carmona

is running neck and neck with republican congressman jeff flake.ra in connecticut, former wrestling executive linda mcmahon, a republican, is battling democratic congressman chris murphy. in indian republican richard mourdock, who deatcaed incumbent senator richard lugar in the primaryis in a fight tofi the finish with democratic congressman joe donnelly. and in north dakotaformer state attorney general heidi heitkamp is staring down republican freshman congressman rick berg.ta the outcome in these and handful of other races, including in massachusetts, montana, nevada, virginia and wisconsin, could easily determine who controls the senate and the president's agenda come january. here to walk us through the stakes, are shira toeplitz of "roll call" newspaper, who joins us in the midst of a rust belt reporting tour. and nathan gonzales, who keeps track of senate races for the rothenberg political report. welcome to you both. shira, it's not an accident you happen to be in indiana while

news is being committed. i suspect you're responsible u'r rome of it. in fact, it's richard mourdock, the republican senate candidate, who at a debate last night in indiana, was quoted as saying this when he was asked about whether there should be an exception for rape in abortion. he said, "i think even when life begins in that horrible situation of rape, that it is something god intended to happen." why did he say that? what did he mean? ask what was the fallout today, shira. >> reporter: right, so right after he said that, and after the debate, he went to the spin room and he spoke with reporters, myself included, we tried to get some clarification for those remarks, and basically stood by the remarks. i think his intent was clear, but he thought he was being misunderstood. the confusion led to a seconds press conference this morning in indianapolis, more than two hours away, where he sought to clarify his comment agains and he ended up policies for them, but only only to those people

who misunderstood him. >> ifill: it not only irred up members of another republican candidate who made dubious comments with rape, but reverberated all the way to mitt romneyutnd his campaign. >> reporter: it did, it did. and it's especially for theinent because mitt romney recently cut a television ad for richard mourdock here just last week, and that was seen as a real boon to richard mourdock's campaign murdoch's fate, in many ways, relies on therdpresidentir contest. but you brought up todd achin' who several weeks ago made a horrific gaffe about abortion. it's the similar case because the words both are to do with abortion but it's a different set of words and i think it's important to make those distinctions. richard mourdock said he s talking about his beliefs, and todd akin was stating a factual inaccuracy about biology. >> ifill: that women's bodies hut down and there is not

pre ancy. he said he made a mistake. today, that's not what we heardn richard mourdock say.rd one more thing i want to ask you before i move back to nathan here, which iss hi competitor, joe donnelly, the democrat, he is also pro-life, right? >> reporter: year, absolutely. joe donnelly iso anti--- does favor-- excuse me, he is pro life, he does, however, unlike murdch allow for exceptions for the life ch the mother, incest and rape. >> ifill: how close is this race and how much would something like this matter? >> i think before the debate even happened as we analyzed it this was an extrely close race. we had it in a toss-up tilting category where we gave murdoch the advantage because of the fundamental nature of thely sta. believed by the time we got to election day a mitt romneyv victory would pull richard mourdock across the line, and before the debate, it looked like murdoch was starting to coalesce the republicans still on the sideline whose loyalty was to setor lugar. now we're in this htding

pattern waiting to see whether those moderate republicans, the loyal lugar, and that's why we moved the race to a pure toss-up. i think it's unfair to say now that murdoch has a distinct advantage, and i think this is going to be a close race and one the republicans couldn't afford to be worrying out this late in the game. >> ifill: a lot of toss-ups. let's smar start in connecticut, where linda mcmahon, is spending a lot of money to have at least a really good shot on it this time. >> i think the democrats made a miscalculation this time around. i think because they thought linda mcmahon ran and lost in 2010. ote spent $50 million of her own money. they thought ife she couldn't gi across the line in a good republican year, there's no way he wilshe will win this time shs

now in a competitive race with chris murphy. he will have the advantage of the presidential race, but it's still competitive. >> ifill: shira, you have written about the north dakota of senate race, another one of these tight races, heidie, heitkamp, jrs rick berg, the republican, and energy is a big issue in that race. >> reporter: absolutely. north dakota has lowest unemployment rate of any state in the country, ai that's because the oil industry is absolute booming out there, especially in the western part of the state. now, this plays into both candidacies. obviously, rick berg, a freshman congressman, but he was a longtime state lawmaker in the state. he was dealing with a lotf these issues. and hide, former state attorney general let public office temporarily, obviously she's running ain now, in 2000in and went to work at an energy company. energy is huge in the state and huge if the race. >> ifill: thanks for correcting me on the candidate's name. i called him something else but it's rick berg.

gled let's move to arizona,nd that's also very tight in a a state which hasn't elected a democrat to the senate in house long? >> it's because, you know, this is a surprise retirement with senator keil, and i don't think republicans were expecting defend here. but this is a close race. what we're looking at there is carmo had his own debate gaffe where he basically insulted cnn's can crowley,n even though she wasn't in the room at the time. i mean, at best it was a crude remark, and we're seeing whether it was-- it will have further ramifications. it's a close race, butce jeff flake went through a late republican primary, piled up a lot of negatives from his opponent spending millions of dollars against him, and it looked like flake will have the advantage there, but it's very close, and republicans can't afford to lose their own seats if they want to take over enough democratic seats in order to win back the majority. >> ifill: they need four seats

to take over the majority if the president wins, and three seats ifmnitt ro ey wins. >> correct. and vice president paul ryan would be the tiebreaker. >> ifill: chirac, of course we t can't talk about anything in politics without talking about ohio. you have been to ohio where there is a surprisingly closec oce going olo the incumbent, democratic senator brown,against republican tea party-backed candidate josh vandle. >> this is another competitive race, a similar to indiana, but in a different way, the fate of this race is tied closely to the presidentiale, contest. rnother really unique thing howh muchs race i outside money has poured into thisch contest. sherrod brown on the trail likes to talk about the $24 million in advertisement, important to the state, into his specific senate race, starting as early as six to eight months ago. obviously, ohio voters who have been watching their television sets and sick of seeing the presidential contest ads, they're sick of seeing these ohio senate ads, too.

>> ifill: and pennsylvania, you must have driven through this, bob casey running against tom smith, the republican who no one gave a shot to but had the airwaves all to himself for a long time. >> reporter, absonttely. tom smith is a former coal executive from southwestern pennsylvania. he's quite wealthy. he's put17 million of his own money into the race and he did something very key. he went up o philadelphia media market anddt tbebefore casey could afford to do so and it really gave him an edg we saw in this race, when republican senate candidates were falterg at the end of september when the tpresident ws on the uptick, tom smith was actually going the other direction. he was gaining ground on bob casey. and now most people in the straight stale think bob casey is going to pull it out but it's going to be by a much smaller margin than many anticipated.

>> ifill: what do you think of pennsylvania? >> the drippancy lies if you think mitt romney is going to win pennsylvania, those are the same polls showing tom smith running close to bob casey. we think a romney victory in pennsylvania is unlikely, and, thus, i think casey will be okay. i think it's important to remember on election night because we have so many of these close cases. we could have recowntsz. we could be waiting on former governor king in maine who he is going to caucus with, and we may not know who will be in the majority until days, maybe even weeks after election day. >> ifill: is there any connectionifo be made between what's happening at the top of the ticket and happening in the races. it seems in some cases you can't take what's happening ino the natnal scene and connect it. >> tenre are tens of millions of dollars spent in the competitive senate races and enough where they can almost stand alone, where voters can get familiar with the candidates, choose between candidatend quality, campgn qualities.

it does affect on the margins. ohio and florida looked like they were slipping away from mitt romney. thoca senate races started to slip away from republicans. when you look at the cross-over ste in north dakota, where heidi heitkamp, the better mitt romney does, i think the harder it is for heidi heitkamp to wino that race. >> ifill: nathan gonzales, and shira toeplitz, crossing the country there for "roll call," thank you so much for joining us. >> brown: and we turn to another kind of look at the election. we call it "missing issues": important topics on the american agenda that neither candidate is spending much time discussing. tonight, our subject is housing. it wathe housing bubble that helped lead to the financialus crisis in 2008 and has continued to drag on the national economy. the presidential candidates have there's been better news recently as the housing sector has shown new signs of life. just today a new report found sales ofew homes rose 5.7% in

september to an annual rate of 389,000.ew that's the best pace since april of 2010, and continues an upward trend in recent months. and, the average price of new homes as risen more than 14% in the last year.me but big problems remain. more than 20% of u.s. homeowners are underwater on their mortgages, meaning they owe more than the value of their home and some 950,000 homes are in the process of being foreclosed on currently. last october, mitt romney took a largely hands-off approach to the problem. >> don't try and stop the foreclosure process. let it run it's course and hit the bottom. >> brown: but by january, the republican hopeful was quoted by "the new york times" as saying, "the idea that somehow this is going to cure itself, all by itself, is unreal." in a republican primary debate >> if he is reelected i'm convinced you will see the value

of your homes going to the basement and quafyings for a mortgage will be difficult as >> brown: the obama administration has made several attempts to address the housing problem, with only limited success. more than one million people have received a permanent loan q modification through one key initiative, but that's far short of the three million plus that it was expected to help. last february, the president pushed to expand refinancing options. >> i am sending congress a plan that will give every responsible homeowner in america the chance to save about $3,000 a year on their mortgage by refinancing at historically low rates. >> brown:he proposal went nowhere and, like romney, the president has not spent much time discussing housing on the trail. that's despite the fact that four of the swing states in thep esidential contest have some of the highest foreclosure rates in the country. meanwhile, there's action in the courts. federal prosecutors in new york sued bank oamerica for $1 billion today.a

its countrywide unit allegedly solfraudulent mortgage-based loans to fannie mae and freddie mac, prior to being acquired by bank of america. w so little focus on this? and what should the candidatesi be proposing, if anything? we examine that with james carr, a senior fellow at the oppounity agenda, a policy and advocacy group.ag he's a former senior vice president for financial innovation at the fannie mae foundation. dd mark calaia is director of financial regulation studies at the cato institute. he worked on housing policy as a republi n senate stan er and at the department of housing and urban development. welcome to both of you. i want to start with this question of the "why" question, jimnd carr. why does this get so little attention? >> first of all, jeff, thanks for inviting me and thank you for actually having this conversation which has been misr.ng from the airwaves. i think one of the reasons candidates haven't been held accountable by the press, by the media. you look at the fact m 've had three presidential debates and

not a single question on the state of the housing market. i think the second thing is the housing market haso many problems we're trying tony fig t the fix is politically challenging and controversial. the banks have their solution. theirs, housingir consumer groups have theirs, liberals and conservatives have theirs. it's a sticky political environment to tread into unless soeone forced you to go there. >> brown: i guess, richard mourdock, the candidates don't want to talk about it too much. >> well, the most simply, the negatives outweigh the positives. let's think about some of the negatives. the president has had a number of programs that haven't lived up to his own expectations and i think they've been roundlyve criticized so for him not talking about that is probably a preference. for mr. romney the issues are partly devices. so to go out and talk about helping one homeowner versus another. a number of people need help. a number of people are tired of

theailout. they want to bail out their neighbors. one of the reasons it's divisive is many of the solution offer read redistributive. you will help citizent a. at the expense of citizen b., citizen b. will not be happy with you. a lot of the real estate industry, tend to be very small business and very pro republican. what romney is trying to balance tea don't want to irk the party folks and say i will give bailouts but i don't want to talk it down too much because my friends in the real estate industry want to see the prices go up. >> brown: what should people know about the state of the housing sector today? we were ticking off some of the negatives and positives. what is your overview we should know? >> i think the public should know several things, despite the good news,hi the housing market remains in big trouble. we have lost $7 trillion of housing equity. we are nowhere near havingng regained that. are than 30% of households

upside down on their mortgages.a we have $700 billion of loans that are literally underwater, the value-- $700 billion of mortgage credit that is in excess of the actual value of the homes underneath. and so-- and trying to get a loan has never been harder. typical down payment now, 20% or above, typical credit scores are 750. in a sense, the banks are over-compensating for the reckless underwriting that happened before the crisis to the point where peop who are eligible for a loan just simply can't get one. and the other thing i'd say is there's not a real focus on the value and the significance of a strong housing market to job creation and the economy. and i think that conversation is missing from this debate. >> brown: what would you add to that and you can start our look at what they should be talking about. >> absolutely. the first thing toro keep in mi, i think as far as prices, the worst is behind us.

we have declines in some markets and increases in some markets. u i can't over emphasize every housing market is different. phoenix is not atlanta is not new york. you really do need to look at local conditions. but flay broader sense, one of the things that concerns me is ultimately whether it's five, six, 10 years we'll get to the int where people believe housing prices will never go down again. housing can be a great investment. it can be a stable investment. it can also be a very risky investment. i think people need to go into this with their eyes clear, making sure what they're buying is really based on their needs and not the ability to flip it. >> brown: why don't you start, what do u wish youdo had heard in the debate? what do you wh you heard outo the campaign trail today? what do you want to hear? >> toh tell you quite frankly, i was far more sympathetic to where governor romney started out, which is this is a process that needs to work its way out. the prices need to hit bottom. i think this is a problem of we built too much housing and the only way you work off excess

supply, in my opinion, prices fall and i appreciate and respect that he said that first. i think he is starting to recognize the politics of it after t at.at as an economist, they call economics the dismal science not because we say happy things but because people don't want tout hear. >> brown: that market not working means a lot of people are hurt. >> it absolutely does. we have lost $6.5 trillion in wealt there is no magic wand. there is no way to bring that wealth back. you need to have the market recover and that is going to be painful. i would have ked to have heard, a., the market is going to go through adjustment. it's great for renters who want to get into the market and when the prices looko good againt will prevent opportunities. the it should be how do we find help people whose position ist not sustainable, how to transition to a better life, a better world. i think i'd like to hear the concnef keeping the market in limbo indefinitely is not aep lution. trying to fight the fundamentals of the market is not alu soluti,

but trying to work with the way the market is going is the direction to go. >> brown: you'd like to hear a little more government proactive. >> absolutely. just to create one of the statistics gave, i meant to say house pr ies remain more than0% below their peak an0% more than 20% of households you are upside down on ther loan. i think when you look at we have 11 million foreclosure filings, ande homes 60 days or morea delinquent, and millions more at high risk of foreclosure, sitting back and saying we're going tlet the market work itself out is a prescription for a long, protracted, or even a pretty sudden drop in home values. the fact of the matter is the programs are not doing exactly as we'd like them to, but they are having a significant effecth the challenge is not that they're doing nothing. it's that we need to step up the game on the foreclosure mitigation initiatives and really stem this foreclosure

crise. gad then the second part is we need not to ignore that the housing market needs to be rebuilt. the secondary market needs to be restructured. and we need to dive into that conversation and rebuild it so that people who are eligible for home ownership right now actually can access the system, which millions can't do aw. >> brown: i assume parent of the politics here is one of these issues has been with us for years, which is the degree to which individuals are responsible for their own problem. and, therefore, to what extent the government-- or the rest of us-- should be helping them, people who might have borrowed too much. >>he economist in me is if you wanto grow family wealth and income over the long run, the way to do it is you have to make labor more productive. that's what drives wages ando income. i worry that we got a series of essentially asset bubbles. we r up hose prices and now the feds and others are trying to run up stock prices. house prices don't make anybody more productive. they don't rasee your wages in the long run.

housing is consumption. i think policies that try tour make housing a great investment and consumption at the same time are in conflict. ultimately, i worry that we're rin vesting our nation's resources in things that do not grow wages but simply make us fema wealthier. it's not actually sustainable in the long run. >> brown: we will have to leave it there but we raised the questions at least. thank yoboth veryk much richard mourdock, and jim carr. >> we wi examine other misses issues in the coming days. >> ifill: the campaign spotlight may be missing some issues, but it is also missing me of the candidates, including four whoin are running for president. last night they held their own debate in chicago. kwame holman has our report. >> reporter: with the presidential race in a dead heat, between the two major contenders, third parties could draw just enough votes in me states to tip the balance. >> look, there is only a couple of voices being heard here, and

it's tweedle dee and it's tweedle dumb. >> reporter: the libertarian party nminee gary johnson was one of four alternative candidates featured in last night's debate at the chicago hilton hotel. jill stein of the green party also took part, along with the constitution party's virgil goode and rocky anderson, nominee of the justice party. the non-profit free and equal elections foundation hosted the debate, and former cnn hostmi larry king moderated, with questions culled from social media. there was some momentary confusion at e outset. >> let's go ahead and do opening statements. my apologies. >> i didn't know we had opening statements, i thought we were right to the questions. >> reporter: the candidates then proceeded to address everything from lting the war on dthgs to reducing military spending to curbing the influence of money in politics.on the justice party candidate, rocky anderson. >> the corrupting influence of money in this country is at the root of every major pub policy disaster. it's why we don't have

healthcare for all as in rest of industrialized world, it's why we aren't providing international leadership on the climate crisis, because all corrupting money coming from the fossil fuel industry. >> reporr: on that subject, gary johnson, a former republican governor of newth mexico, said transparency is key. >> i think when it comes to political campaign contributions that candidates should have to wear nascar-like jackets with patches on the jackets. >> reporter: on the war on drugs, most of the candidates agreed it's time to legalize marijuana and more. green party candidate jill stein: >> marijuana is a substance that is dangerous because it's illegal. it's not illegal on account of it being dangerous, because it's not dangerous at all. >> rorter: rocky anderoron echoed that sentiment. >> we need to end drug

prohibition just like we ended alcohol prohibition and treat drug use and abuse as a public health and education issue and get it entirely out of the criminal justice system. >> reporter: but virgil goode disagreed. the former congressman from virginia was once a democrat, then a republican before joining the constitution party. >> let's be clear about my position on this. unlike gary, rocky and jill, i'm not for legalizing drugs. if you want that, vote for one of them, don't vote for me. >> reporter: all of the candidates agreed on another proposition-- that the pentagon's budget is too high. >> a foreign policy based on militarism and brut military force and wars for oil is making us less secure not more sece. we need to cut the budget and bring the troops home. and we need to end the dronee. wars. >> we should not bomb iran.

we should get-- we should end war in afghanistan tomorrow, bring the troops he tomorrow. >> if i'm elected president i'l balance the budget and part of the cuts have to be in the department of defense. we cannot do as mitt romney and paul ryan suggest, increase military fundg by $2 trillion2 over the next decade. >> reporter: to get on the stage last night, the candidates had to be on the ballot in a minimum numr of states. or, they had to be polling atta least 1% in any national sur y. in the case of virgil goode, republicans tried to keep him off the ballot in virginia, fearing he might siphon votes from mitt romney. goode took on both romney and president obama on student loans, pell grants an rising tuition costs. >> you might not get what you want to hear from me, but you'll get straight talk. we can't afford more federalg subsidized student loans and we

can't afford more pell grants. >> reporter: but jill stein and rocky anderson argued tt thet real problem is that the obama and romney prescriptions for higher education don't go far enough. >> i think it's time to make public higher education free, as it should be. >> we cannot afford not to provide a great educaon and an equality of opportunity for all onof our young people in this country.o >> reporter: gary johnson, however, said the loans and grants are to blame for the rising cost of higher education. >> that is another one of government's unintended consequences that have college tuition at such a high rate. >> reporter: recent history suggests the independent standard bearers can have an effect. in 2000, green party candidate ralph ader took votes from democrat al gore in florida and other key states. and in 1992, ross perot captured nearly 19% of the total vote in his race with the first

president george bush and bill clinton. 20 years later, he's endorsed mitt romney. >> ifill: you can watch the rest of the third party candidates' debate online. that's in the rundown. >> brown: now, a question you might not have pondered before: what can a medical center learn from an auto manufacturer? "newshour" health correspondent bey ann bowser has the answer.bo >> reporter: 63-year old robert sherrell had no idea lower back pain could hurt so much. >> i was like wow what was that and it was tremendous weakening and just took me right down. >> reporter: sherrell is among the 80% of all americans who will have a bad back sometime in their lives. and when that happens, many patients undergo an m.r.ti, an

expensie imaging test.e but nine leading doctor specialty grouprecently said m.r.i.s are often a waste of money andreedically unnecessarya doctorsere at the virginia mason medical center in seattle take that to heart. they have use special softwareer at the lower back pain clinic that rejects any order for an m.r.i. ,unless a long list of criteria has been met. >> if there is no evidence based indication, the test cannot be ordered. >> reporter: virginia mason's dr. robert mecklenburg says in justhree years they'vehr eliminated unnecessary procedures and saved money. >> we've seen well over 10,000 patients in this clinic and their return toork is twice as fast as the old style of backn pain care that we delivered before. the patients satisfaction is much, much higher and the cost of delivering case is much less. >> reporter: the software is

part of the medical centers r on waste that started more than ren years ago.rs at the time the medical center was losing money and dr. gary kaplan had just been named c.e.o. >> waste is all those things which add no value for the customer. it's embarrassing frankly because we find most processes 70% to 95% of time that's spent adds value for the customer. dde waste of wait, the waste of movement, the waste of over processing, the waste of excessive inventory. all that is waste and it had no malue. >> reporter: kaplan learned that lesson from studying the philosophy behind the world faous toouta production system. it's based on the idea that if waste is rooted out along the assembly line the result is better cars and lodur costs. some of what toyota does mayr sound like common sense. but when a little bit here and a

little bit there is applied it can add up to big saving that can mean anything from returning patient phone calls faster to moving supplies to where the patients actually are. the prestigious institute of medicine recently zeroed in on waste. in a new report it said $750 billion is wasted every year in the american health care system. it also recommended more teamwork among doctors and nurses saying that would make ntre more efficitnt. at the kirkland clic in suburban seattle team work is a mantra. that's why rhon c chiuchta goes there for health care.ht >> i just go straight to the check in counters. ey give me a card and you go straight to your room and within a couple of minutevea care nursu comes into the room and checks your weight, checks your height, blood pressure and then she

calls the doctor in and we just update and talk about what's going on. >> reporter: and, chiuchta doesn't was a lot of time waiting to see the dastor because there are no waiting rooms. >> it's just an embarrassing reminder of how inefficient we are in healthcare delivery. it's just a shame to see how we spend huge amounts of money for fancy waiting rooms. >> reporter: virginia mason is slowly getting rid of waiting rooms at all its facilities. they've been able to do this by takg calls for appointments as they come in instead of letting them back up at the end of the day. all of this has meant the staff has had to change the very basic ways they think about the delivery of health care.s here it's the medical assistants, or m.a.s who control the work flow. >> this is the flow station, and

this is the place where the provider and the m.a. work together. the m.a. we call flow manager, and the fw manager isw directing us. >> reporter: like a traffic cop? >> like a traffic cop. >> reporter: dr. richard furlong is medical director of the kirkland clinic. >> the physician takes directions from the m.a. and that's a change for providers to accept direction from an m.a. the work is spread across the chain and we are no longer the center of the universe, the patient is, and it's the team that's delivering the care. frankly i think it was hard for the m.a.s at first, but we broke that down and now i think if you watch them they actually enjoy bossing us around. >> good morning. >> reporter: kapl and his staff first got the idea for a doing these sorts of changes when they started visiting toyota in japan back in 2002. they were convinced at some ofat big car makers philosophy would

work in seattle, but it was a hard sell to the staff of 5,000. >> i would say in the beginning we maybe had 10% early of doctors you know really champions of this work and then were 10% over my dead body you know i'm not going there and then 80% in the middle. >> reporter: what the doctors didn't like was something that happens all the time on the toyota assembly line. >> it's really fascinating. they make 1,000 cars a day in thfactory, there are 350 workfars and if the wo er doesn't have what he needs to do his job or sees something that he's concerned about he can pulh the cork and stop the entire factory. it was mind blowing. >> reporter: today that is more than just an idea. every employee is expected to port any serious safetyny concern they may have. it's helped reduce liability

costs by 60% since 2004. it's also led to better patient care. the hospital's nursing staff has also part of the change. charleen tachibana is senior vice president and hospital administrator. >> we really started looking at where nursewere spending their time and we found that they weren't spending it with patients. >> reportewe in fact, they were spending too much time collecting supplies and drugs ordered for patients by the staff. so patient supplies were removed from a central storage room and put into hospital rooms at bedside. >> through a variety oct changes we wound up taking about ourge nurses time from 35% in direct contact with patients to upwards of 90% of their time in contact th patients. >> reporter: but there have been bumps in the road. some traditional health care

thinkers say the medical center is practicing a one size fits all form of medicine. but kaplan and his staff remain committed. >> the caseor change is compelling. the resistance to change and the anchoring in the status quo in still very strong and so that's our objective here.or we talk at virginia mason about transforming healthcare and some may say well it'delusions ofon grandeur and all we really want to do is show what's possible. >> reporter: a number of hospitals are now experimenting with toyota production system principles. meanwhile virginia mason was recently named hospital of the decade a re aected healthcare rating organization. >> brown: what's to blame for rising health care costs? we break down seven factors that drive up spending. and what could we buy with the billions of dollars wasted?h our io-graphic o-fers some examples. plus, you can see a comparison

of u.s. spenfeng on health care compared to other nations. all that is online. >> ifill: finally tonight, an inside look at the shrouded ngdom of saudi arabia. the country seeme oan oasis of calm during the turbulent arab spring, but that stability is shifting. within the last decade, there have been a number of terrorist attacks, including one in 2003, when suicide bombers struck a compound housing foreigners, killing nine americans.ee pulitzer prize winning author karen elliott house has covered saudi arabia for 30 years, often getting rare access to a vast spectrum of its society. judyttoof uff talked wedh her recently ababher new book: "on saudi arabia: its people, past, religion, fault lines and future."ne >> woodruff: karen elliott house, thank you for being with us. >> thank you for having me. >> woodruff: so the book "on saudi arabia" why is it

important for americans to understand saudi arabia? >> because it's country wee very dependent upon for oil and dependent upon to keep the people from becoming terrorists and trying to kill us. so for both our life and our livelihood, we should try to understand the country. >> woodruff: there's such a sense of saudi arabia being the one stable country in the midd east. we don't know very much about it, but it seems to have things under control. but the title of your first chapter is "tranquil." how fragile? >> i think they do have serious problems. they have problems other countries have of unemployed youth, 60% of the population is under 20 years of0 age. they have a lot more money to deal with it. but it doesn't diminish the frustration young people feel now that they, threw the

internet and satellite tv, have an understanding of what goes on, not only in their country but in the wider world. >> woodruff: hows that this regime-- you write so much about the history of what you call the house of asud. asudhow have they managed to keep conol for so long? >> they use a combination of dividand conquer. make everyone fear everyone else. religion. they teach their version of religion teaches that you must obey your rulers, even if they're bad, because when god wants you to have bette ones he will provide. so obey or otherwise you willet have chaos. and the third thing ishi money. they give a lot of-- they have a lot of money, thanks to oil wealth, and they slather it across the m country. but people still see that-- that their level of living is

declining, and they know there's a lot of money in the country. so they get frustrated by that, too. so even the money has less and less utility. >> woodruff: and speaking of the frustrations, karen house, you spent five years in and out of saudi arabia working on this book. you had extraordinary access for a journodist and you were telling me a minute ago, the fact that you were a woman madeu it even-- it made it easier for you to get information. >> yeah, most people think, oh, if you're a woman that must be very difficult. and it's actually a big advantage because for a western woman, you're an norary man in saudi arabia. i can talk to men, but i can also talk to women. and there are, clearly, a range of modern and sophisticated

women in saudi arabiate whose husbands allow them to talk to men to whom they're not related, but that's not the norm, so i can really talk to women on the whole female spectrum from the very conservative-- i lived with a very religious conservative woman-- all the way to women who are running their own businesses and to men. >> woodru w: a country of contradi: ions. i mean, you write about the incredible wealth, the loo way y the government has given religiios leaders to set down rules and you talked about how that has come back to bite theer regime because it unleashed terrorists who were involved in 9/11. >> after the shah in iran, and the emergence of a religious theocra there, the saudi royal family became very nervouse, abt we mustn't be seen as worldly.

we must be seen as religious. and basically, turned the country over to the fundamentalists. and then after 2003, when those people began blowing up things in saudi arabia, they realized they'd made a pact with the dech devil, and king adbullah has tried to have a kinder, gentld version of islam, but it takes a long time to change the course enat they bred into people for 20, 25 years, and longer. >> woodruff: how nervous is the regime itself doatyou think? and what do you see in the near term, the future for country? >> i think the regime's nervous about the conditions inside the country-- high unemployment, restless youth, more women wanting work, et cetera. their biggestix of, i think, source of nervousness is iran.

but their biggest issue is their own succession, the crown has gone from one brother to another. they are now neither the end of tht line of brothers, so you're going to have elderly and infirmed leadership for-- they have had and they will continue to have because the youngest brother is 68, 69. and somewhere they're going to have to pas to the next generation. and that's not so easy when there are 34 surviving brothers with braerch branches of familih many sons and all of whom could be king. so it's a difficulty for them >> woodruff: karen elli tt house, the book is "onel sowdia it's people, past,ings are." >> ifill: you can see more of judy's conversation with karen elliott house about the lives of women in saudi arabia

on our website. >> brown: again, the major developments of the day: neysident obama and mitt r loggn thousands of miles, covering states where the election remains a dead heat. the federal reserve reported the economy is improving moderately, but hiring remains sluggish.lo and in the caribbean, late- season hurricane sandy struck a blow at jamaica. online we have a follow-up to our story about the automatic budget cuts that could affect virginia's defense industry. hari sreenivasan has e details. >> sreenivasan: hear what voters have to say about jobs, the economy and the abity for congress to find a compromise. that's part of our "battleground dispatches" series. a and on making sense, we announce the winner of our economics song contest. and the prize goes to: "deleveraging is hard to do" to the tune of "breaking up is hard to do." find the lyrics on our business page. all that and more is on our web site newshour.pbs.org. jeff? >> brown: and that's the "newshour" for tonight. on thursday, we'll have the latest on the presidential race. i'm jeffrey brown. >> ifill: and i'm gwen ifill.

we'll see you online and again here tomorrow evening. thank you and good night. major funding for the pbs newshour en prod by ♪ ♪ moving our economy for 160 years. bnsf, t engine that connects us. and with the ongoing support of these institutions and foundations.

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